Why do we sideline our medicine?


Why do we put ourselves as acupuncturists and EAMPs in such a tight career bracket? After school, it feels like we have one option: to open our own practice and do acupuncture and herbs, or else leave the medicine.

I’ve sought to expand this by trying to get another conventional medical degree, but that isn’t working out. So I’ve been asking myself: if I don’t want to be a small business owner and I want to work with underserved and marginalized populations, what can I do as an EAMP?

Last year, I had the good fortune and networking prowess to make a volunteer position I was doing turn into a paid position at the Seattle Institute of East Asian Medicine. The future of this position is uncertain, but for the past year, we’ve been able to provide free acupuncture to low income seniors affiliated with Pike Market Senior Center, while I as an acupuncturist get paid. This is wonderful, but not enough.

Two weeks ago, I got a job at DESC, an organization that helps people who’ve lived in chronic homelessness. My new position is support and resource people who have received housing so that they can maintain stability in their lives.

This is medicine, and it is fully in the scope of the role we have as EAMPs.

As CAM providers, it seems like we feel that we need to practice the most literal interpretation of our medicine to be practicing. In order to do that, we’re reliant on people being able to pay out of pocket or have excellent insurance plans that cover CAM without too many restrictions. This limits access to our services to many people, and in this way we perpetuate inequity. It’s as if we’re saying that only middle and upper income level people deserve holistic healthcare. Services like community acupuncture seek to address this, but in a way that is incredibly difficult for anyone but the owner of the clinic to make a living wage working there.

By doing this, we’re sending a message, and that message is that our medicine isn’t essential, and that practitioners of our medicine shouldn’t expect the financial stability of conventional medical providers.

It’s been my experience that CAM providers are incredibly idealistic about their medicine–it’s part of what makes us accept the far lower wages and uncertain employment. We become holistic care evangelists, perpetuating a dichotomy of us versus them in the “allopathic” medical community. This only serves to further the above message that we’re not essential, and we are cut off from being a part of larger medical systems that would allow us access to more patients that could benefit from our care. We lag behind in addressing social inequity and trauma-informed care, despite being in a great position to be a part of that movement.

We need to start getting ourselves into these systems in whatever way we can if we’re going to change this. We have something extremely valuable to offer–validation of people’s subjective feelings of being unwell. If we’re to do this, we need to learn to get over ourselves. The forms we currently utilize in our practice is limited. If we’re in medicine because we wish to be healers–something you hear a lot of from CAM providers–we must be able to make our medicine work for all people, including ourselves.

I have my first job with guaranteed income and benefits for the first time in years. No, I won’t be sticking needles in people or recommending herbs, but I’m still working to benefit people and help them live to the best of their potential. Isn’t this what we’re trying to do in medicine?

I have a theory that I’m putting into practice by taking this job that if I put in my dues, I can find my way back to working under the capacity of a licensed acupuncturist. I believe that what we have is of value to underserved people, and that we can be an ally to them in receiving the full range of care they need. I think our scope is broader than we think, if only we’re willing to extend ourselves.

The power of subjective experience.

As an acupuncturist applying to medical and nursing school, I find myself sitting in an unusual space. I love science, and do not believe that there is any inherit superiority in natural medicine. Yet neither am I going to dismiss the positive effects I see in my acupuncture patients simply because I don’t know how it works, or if the modality is scientifically valid.

The space I reside in mentally regarding my profession has clarified in recent years as I delve into my hobby interest of ecology. Studying the works of such scientists and historians such as Robin Wall Kimmerer and Bathsheba Demuth, and philosophers such as David Abram, I’ve come to have a new appreciation for the subjective. Often called by the belittling title: “the placebo effect”, I think we as a species do ourselves a disservice by downplaying the power of subjectivity. Scientific, so-called objective reality being the norm is a very recent phenomena, and one that comes with a fair amount of baggage in its own right. By distancing ourselves from the natural world, putting a microscope between us at it, we often fail to see ourselves as a part of it.

For most of our existence, humanity has worked to define its place on earth and in the cosmos. Various subjective religious and spiritual experiences and frameworks gave us a way to integrate ourselves into something larger than ourselves. The more we compartmentalize and dissect, the harder it can be to see and identify with the whole. Ways of thinking that allow us to tap back into that may not be scientific, but they may still be necessary. Research is coming back that having faith, a belief in the intangible, helps people live happier, more fulfilling lives. What they believe in may not be scientifically true, but that doesn’t detract from the benefit they receive from it.

The shamanic worldview that Traditional Chinese Medicine (TCM) was born from has been with humanity for centuries. Nature-based religions such as shamanism played an important part in the development of our species. While we may no longer believe in spirits and ghosts, I believe there is a part of us that still longs to connect with the land and the earth in an elemental, almost mystical way. The phenomena and popularity of the idea of “forest bathing” shows us a little of that. TCM, with its method of looking at the body as a dynamic network of systems that all play off of each other and root back to various elements of the Earth, also strives to do that in its way.

There is a notion that science can explain everything if we throw enough time, energy, and money at a problem, and that an understanding of the world built on science is superior to an uninformed, subjective view. I know I’ve often thought that way, even as an acupuncturist. Yet I can’t help but wonder if the recent pushback we’ve seen in this era of “alternative facts” has been some misguided attempt at reclaiming power in our subjective reality. When I think of it in this light, I develop more sympathy for those that wish to claim the world is flat and the like. Perhaps if we gave more credence to the subjective in addition to the scientific, we would find ourselves at less at loggerheads, and we could work at channeling this need for subjective validity into repairing our relationship with the Earth.

Robin Wall Kimmerer posits that there there is a healing that can happen if we are able to develop a sense of having a reciprocal relationship with the Earth. Founded on an indigenous worldview where the land is imbued with animacy, she and other academics who are looking into this worldview question why we are so quick to dismiss it if it leads us to have more reverence and respect for the world around us.

Coming from the field of CAM, my curiosity about this question has gone one step further. Could the popularity of “natural” medicine come from a subconscious urge to be more in sync with the Earth? Within the CAM field, I find that there can be an unexamined tendency to believe “natural” medicine is superior in some way, even if its outcomes are often less certain or studied. I don’t personally hold this view, and am just as likely to take a prescription and talk to my allopathic doctor as I am to use herbal medicine or another complementary modality. Yet the feverishness that some cling to this, such as in the movement that questions vaccines, has lingered despite the evidence that should reassure. If this is the case, might we, instead of dismissing people with these concerns as

Coming from the field of CAM, my curiosity about this question has gone one step further. Could the popularity of “natural” medicine come from a subconscious urge to be more in sync with the Earth? Within the CAM field, I find that there can be an unexamined tendency to believe “natural” medicine is superior in some way, even if its outcomes are often less certain or studied. I don’t personally hold this view, and am just as likely to take a prescription, get a flu shot and talk to my allopathic doctor as I am to use herbal medicine or another complementary modality. Yet the feverishness that some cling to this, such as in the movement that questions vaccines, has lingered despite the evidence that should reassure. If this is the case, might we, instead of dismissing people with these concerns as recalcitrant, look at what lies below the surface? If we take them seriously, and work to reassure them that their subjective concerns are valid, might we slowly earn the trust we need to assuage their fears?

Counter to…

I read an opinion piece today in the New York Times titled “How to Counter the Circus of Pseudoscience”.  As a practitioner of “pseudoscience” who aspires to go to medical school, many conflicting thoughts ran through my head, ranging from defensive to sympathetic.  The author is a medical doctor who is highly critical of naturopaths and Goop-inspired natural medicine.  Her main problem seemed to be the overconfidence of many “practitioners” (her quotation marks, not mine) in their scientifically questionable knowledge and methods.  While dismissing and invalidating the entire field of natural medicine and it’s “practitioners”, she also enthusiastically trumpets her own fields ability to reflect on their mistakes and know their limitations– “especially the good ones”.

What about the good practitioners of natural medicine?  Are they allowed to exist in this doctor’s paradigm?  Are we all quacks, with medical doctors alone holding the light to the afflictions of humanity?

What I found this author failed to acknowledge was a very common situation when a person goes to their doctor, and the doctor either can’t find anything medically wrong with them, or possibly even fails to address their needs.  It is here where natural or complementary medicine can be quite effective.  In my own practice over the years, I’ve seen many people with unresolved health problems, whose tests come back from their doctor negative, but who then find results through acupuncture and Chinese medicine.    Can I explain my treatment scientifically?  No, not completely.  Do people find relief from it?  Many times yes, and sometimes no.  And if I can’t help them after a couple of session, I refer then to someone who I think can, and suggest terminating the treatment.

Where I feel like this author went astray is her failure to recognize that people want help with their problems, and if doctors don’t have the softer tools to help them, they’ll look for someone who does.  Neither does she differentiate between natural health “practitioners” who are reckless with their belief that supplements and right living are cure-alls, and those of us who know the limits of our chosen medicine.  We do exist as a breed of natural medicine practitioners, who refer people back to their doctors, who don’t feel comfortable treating people without having the diagnostic testing to rule out more serious underlying conditions, who keep a vigilant eye out for red flags, and who are aware, for better and for worse, that the medicine that they practice isn’t and can’t necessarily be validated by science.

Like many in my field, I got into natural medicine because I wanted to help people, just like many M.Ds.  I thought natural medicine would make a good tool with which to partner with patients to find a preventive healthcare regiment that worked to keep them healthy, and would enable me to spend more time with patients than the average doctor.  I envisioned partnering with a patient’s primary care provider and any specialist they had to help keep track of the patient’s total wellness, each field complementing the others.  This was idealistic and somewhat naive of me, as that sometimes doesn’t even happen within the medical field itself.    So often, we find ourselves “counter to” the medical establishment, and the medical establishment often counters us.  But what if we worked with each other?

Opposition often breeds estrangement, resentment, and lack of trust.  The more the allopathic medical profession fails to see what natural medicine has to offer, the more natural medicine in inclined to dig in their heels and put blinders on.  What would things look like now, if instead of prescribing opioids as a blanket remedy for pain, doctors took the time to really investigate which types of pain issues tended to respond well to acupuncture, massage and chiropractic? What if instead of dismissing the entire natural medicine field as full of  “practitioners”, MDs, ARNPs, and PAs and nurses worked to find the ethical practitioners in the field?  Both fields have their bad eggs, but neither does itself or its patients any favors when it dismisses or downplays the other.